Pakistan: Bigger Dose of Action Needed Against TB

From CDC National Prevention Information Network

June 12, 2003

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According to government figures, four out of five cases of
tuberculosis in Pakistan are not detected or treated. Pakistan
ranks sixth on the World Health Organization's list of high-disease burden countries and accounts for 44 percent of all TB
cases in WHO's Eastern Mediterranean region.

WHO's 2003 World Health Report states that the annual
incidence of TB cases in Pakistan is 171 per 100,000 persons.
Each year, at least 268,000 new TB cases are added to the
existing patient population of around 1.8 million. TB kills
64,000 people in Pakistan each year, accounting for 26 percent of
the nation's avoidable deaths. Most patients are ages 15 to 45;
52 percent are males; and 48 percent are females, according to
government figures.

Pakistan adopted the WHO-recommended directly observed short
course (DOTS) strategy in 1995. In 2000, thanks to a World Bank-funded scheme, the program was expanded to the provinces. Since
2001, the government has been handling TB as a national
emergency. DOTS has been extended to 34 of more than 100
districts, covering 25 percent of the population. More provinces
will be covered by the end of the year, and Punjab, the most
populated province, will be covered by 2005.

However, officials at the federal Ministry of Health
acknowledge that the expansion of DOTS in Pakistan faces many
challenges, including a weak health infrastructure, lack of staff
at the district level and poor integration of TB control with
primary care services in urban areas. Pakistan spends 0.8 percent
of its GDP on health.

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Reports suggest that 96 percent of Pakistan's TB patients
get treatment through the private sector. Many health activists
hold the private sector responsible for the alarming proportions
of TB: They say private practitioners are not trained to diagnose
TB early and treat it properly, which can lead to drug-resistant
disease.

A note from TheBody.com: The field of medicine is constantly evolving. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

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